Albern Spoolstra, DDS

Dr. Spoolstra was featured in Doctor of Dentistry magazine in September 2006

Oral Surgery’s Steady Hands of Experience — By Debbie L. Sklar

Forget “glitz and glamour” — when it comes to results, Albern L. Spoolstra, DDS, sticks with “tried and true.” With his trademark technique, nonchalant style and relentlessness for each patient to have a positive experience, Dr. Spoolstra has seen it all.

Dr. Spoolstra, 62, who specializes in oral and maxillofacial surgery, believes in the same go-to methods that he’s been following throughout the course of his lengthy career.

“The confidence is very high in our office and we don’t do a lot of big flashy surgeries- just good, honest, oral dental alveolar surgery,” he said. “I stick to the tried and true or basic oral surgery methods that I have developed over the years by using chisels and burs to remove teeth. The lack of trauma to the tissue during the surgery produces faster healing, a lesser chance of postoperative complications and a happy patient,” he smiled.

As an oral and maxillofacial surgeon, Dr. Spoolstra is involved in the diagnosis and surgical treatment of diseases, injuries and congenital or development defects of the mouth, jaws and associated facial structures. Treatment may range from the removal of wisdom teeth (third molars) because of impaction or infection, congenital or developmental problems and placing dental implants.

However, his daily duties are centered on oral surgeries in both of his two Long Beach offices. He has systematically reduced the number of trauma cases he handles in order to focus on his specialties, such as sutureless third molar surgery(see sidebar about a new study that shows that Dr. Spoolstra has been decades ahead of his colleagues in his chosen technique.)

“I love what I do because when the oral surgeries are successful, it is like a musical that flows. I don’t foresee retiring for at least another 10 years”, he said. “When I graduated, I had the opportunities to reach out to other things besides general dentistry. I choose to take a rotating internship at the Long Beach Veterans Hospital, which gave me the insight into hospital dentistry and other specialties.”

Now, 30+ plus years later, Dr. Spoolstra, father of seven children and grandfather to seven grandchildren, still enjoys his profession and he continues to be successful at attracting patients from near and far.

INTENSIVE TRAINING

While growing up, Dr. Spoolstra’s father was a carpenter for McDonnnell-Douglas and a butcher in Bellflower, CA.

“People would call him up to butcher their animals, like a steer. We raised our own hogs and steers at home – maybe that’s why I became interested in surgery, “he said.

Dr. Spoolstra’s mother was a homemaker to eight children; he was the oldest son.

“I thought it was too hard and I wasn’t good enough. So, I decided, just like that, that I would become a dentist, and wrote to maybe 50 dental schools,” he said. “I earned the requirements that I needed, I studied hard and I earned better grades, but I didn’t get accepted until my second year.”

Dr. Spoolstra attended Cal State University at Long Beach, and then received his dental doctorate from the University of the Pacific in San Francisco, where he graduated valedictorian, first in his class, before serving his residency at the Veterans Administration Hospital in Long Beach.

The second year he was offered an oral surgery residency. “The chief of the dentistry program said if I wanted the oral surgery residency, I could have it,” he recalled. “I took it, and I did a lot of interesting things. A big surgery at the time was called a mandibular vestibuloplasty with a split thickness skin graft, and we did lots of them. It taught me good surgery techniques and afforded me the opportunity to provide great patient care.

In addition, many orthodontists find Dr. Spoolstra to be an expert in complicated extractions, taking out and putting in brackets on teeth for orthodontists, so they can move impacted teeth that they need, in order to create a perfect smile.

Half of his patients are referrals from general dentists, and the other half from former patients – and they are of all ages.

“A 2-year-old may come to see me for a gingival region, or maybe a tongue tie, while a 100-year-old comes for a toothache or pain somewhere in the mouth,” he said.

Last year, Dr. Spoolstra performed a total of more than 1,150 surgeries.

A recently published study by Peter D. Waite, Chairman and professor in the Department of Oral and Maxillofacial Surgery at the University of Alabama, Birmingham, and Sai Cherala, a graduate student at the School of Public Health, provided the first independent and systematic study confirming the benefits of Dr. Albern Spooltsra’s practice of small flap third molar surgery without sutures, which is less invasive and saves time.

Surgery on impacted third molars is widespread, and there are a variety of surgical approaches. “The prevailing surgical technique taught in modern textbooks is to reposition and stabilize mucoperiosteal flaps with sutures,” Dr. Waite and Mr. Cherala noted. The biggest challenge is to avoid postoperative complications. The focus on this study was to determine whether secondary closure of the third molar achieved superior results in terms of irritation and drainage.

From 2001 to 2003, 1,280 third molars were removed from 366 patients by one oral surgeon. The mean age was 22.13 years, females made up 61 percent of the total and the group was 75 percent Caucasian. All were in good health (smokers and those who had used birth control pills were not excluded, but no one was allowed into the study who had organ transplants, compromised immune systems, anticoagulation problems or diabetes that was not controlled).

“The surgical procedure began with the right and left maxillary third molars and the left right mandibular third molars,” the authors reported. “In the maxilla an incision was made over the tuberosity at the distobuccal line angle of the second molar and extended into the gingival sulcus as a small envelope flap. “The bone was taken out with a large bone gouge or periosteal elevator. A tiny V-shaped cut was made at the distobuccal line angle of the second molar. Gingival tissue in the area of the third molar was not removed and a rounded fissure bur was used to excise the bone. There was no suturing.

Patients were supposed to return in a week, and then a week after that to have their healing process checked. Alveolar osteitis (AO) occurred in just 2.81 percent of the molars removed (normally, incidence ranges from 1 to 45 percent; AO can result in pain, lost work productivity and frequent doctor visits). Only 68 of these gave the patients more pain than they anticipated.

Wait and Cherala’s surgeon followed a flap design that had these advantages: no need to detach gingival tissue, decrease in reflected periosteum, good blood supply to the flap, good exposure of the surgical area and bone support for the flap. No distal wedges were needed. The approach allowed better drainage than conventional techniques. The authors noted that suturing tends to “create a one-way valve that allows food debris to enter the socket, but not easily escape, “leading to inflammation, AO, edema or clot necrosis.

Another advantage noted by the by the study was that the lack of sutures lowered the cost of the procedure significantly.

“Throughout medical/dental history many traditional views have been turned upside down, such as the germ theory, blood letting, cerebral pressure and peptic ulcer disease,” Waite and Cherala pointed out.

It appears that their study shows that conventional wisdom about suturing when third molars have been removed is wrong. Dr. Spoolstra was two decades ahead of his colleagues as one of the pioneers of the suture-less technique.

Even though Dr. Spoolstra likes to stick with the old tried and true methods that he has developed and perfected, rather than the latest and greatest fads, he does attend seminars and reads journals to stay up to date. Although he mostly does two-stage titanium implants, he has been very successful in doing the newer one-stage type and is anxious to see how well they work out in the long term.

“Some of my most rewarding patients have been baby boomers who thought that they would never need to have a tooth extracted, and I have been able to give them an immediate one-step implant,” Dr. Spoolstra recalls. “Their confidence is restored and they are so grateful. I’ve run into the situation where the patient wanted an implant, but the general dentist had not performed that type of restoration before. While working closely with my representative from Strauman, he was able to see just how easy it is for a general dentist to complete an implant, and now he refers cases all the time.”

THE OFFICE

Of course, there is no successful practice without great office help.

Dr. Spoolstra confirms that his office staff – six nurses, which includes three front office staff, two surgery assistants and one recovery nurse – is one of main reason for his success, and gives special credit to his wife, Stephanie, who is the office manager.

“Her management style brings a sense of harmony to the girls that are transmitted to the patient, and it really makes a difference.” he said. “Most of my staff has been with me for 10 to 20 years.” That stability adds experience to the team and builds relationships with the patients.

Dr. Spoolstra said his objective has never changed: “Give our patients the same respect and care that we would like to receive ourselves. We like to make our patients feel special – almost as if they are family and so far, it has worked.”

Of course, Dr. Spoolstra has a number of credentials, including certification by the American Board of Oral and Maxillofacial and Fellow of the American Association of Oral and Maxillofacial Surgeons. In addition, he is a member of the American Dental Association, California Association of Oral and Maxillofacial Surgeons and the Harbor Dental Society.

In his spare time, the Huntington Beach resident enjoys reading, spending time with his grandkids and traveling with his wife and their two youngest children to their ranch in northern Idaho, on the south fork of the Clearwater River. He also enjoys working out, snow skiing and jogging.